Healthcare Provider Details

I. General information

NPI: 1538111893
Provider Name (Legal Business Name): ATMORE COMMUNITY HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 02/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121-C LINDBERG AVENUE
ATMORE AL
36502
US

IV. Provider business mailing address

121-C LINDBERG AVENUE
ATMORE AL
36502
US

V. Phone/Fax

Practice location:
  • Phone: 251-368-6286
  • Fax: 251-368-6289
Mailing address:
  • Phone: 251-368-6286
  • Fax: 251-368-6289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. DIANE RENEE FITZPATRICK
Title or Position: EXECUTIVE DIRECTOR
Credential: RN, BSN
Phone: 251-368-6286